Who has her POA's? Is she competent? If she is so close to the end of her life that hospice is prescribed why would they even consider moving her at this point?
If she is competent she can make her own decisions. If not the POA USUALLY has the power to choose and move her to an appropriate facility.
With more information you may receive more helpful responses.
She is competent and wants to die at home. Her son has POA and does all he can. She is bed ridden at this point and the biggest challenge is getting her on the pot for BM other than that she has catheter and doesn't get up. Yes it is so close to end :(
She is CHF and can't stand or walk on her own. It takes two people to help her to potty chair and that is now getting almost too hard. It is a bedside commode.
As long as she's definitely, but no one can do anything with her against her will, she has must to whatever it is. If you put yourself in her shoes, imagine how you would feel if someone came along and ripped you out of your home against your will, and you were totally competent to say no. Competent people who can still make their own decisions cannot be placed anywhere against their will.
Private, the problem may be that she's asking family members to perhaps give up their jobs to care for her. Should they lose their homes to care for a dying mom?
"Against her will" but it's obvious she now needs 24/7y nursing care. I cared for my mother in her home for four years until her condition (parkinsons, stroke and dementia) could not be managed at home. I couldn't lift her when she continuously fell but her attitude was well EMS will come pick me up. That doesn't happen and they charge huge to come to pick someone up off the floor.
I bought her a rolling walker but she refused to use it around the house, preferring to hang on to the walls and furniture and fell all the time. Eventually, in the middle of the night, she had "the fall", EMS took her to hospital and from there she went to as NH for three years until she passed. She spent those three years hiding in her room, refusing to have anything to do with anyone, plotting and planning to the end how she could get someone to take her out of "jail", wait on her hand and foot, meals cooked to order, room service and instantly running servants ... as I had done ... but, then bedridden, how would she get to the bathroom (if she didn't lose it and someone had to clean not only her but the bed and the whole room of sloshy poop), get a shower, cleaning, laundry.
To the day she died, my mother was fantasizing to go live with someone who could provide all this, but of course that;'s just fantasy.
Your mother is bedridden with dubious bowel control and a catheter. It is time to let her go to a facility where she will have nursing care 24/7. Believe me, however much she doesn't want it, she will be so much better off. You are hanging on to her at home why? Fear, obligation, guilt? Stop it and do what is best for her.
In addition to all the positive comments here about the advantages of nursing home care for your mother, I would like to add my experience. My late husband, who suffered from several diseases, had two serious falls at home, although no bones were broken. His hospice team persuaded me to place him in a nursing home despite his wish to remain home. Despite all precautions on the part of the nursing home, he fell again, causing his brain to bleed. He died peacefully in the nursing home four months later. I am still trying to regain my own health, after using up my own physical resources by keeping him at home so long.
If this lady is mentally competent, then she should really be able to care for herself. If she can't do that, then it's her responsibility to ask for home health care. I had an elderly friend of mine who was very competent and well able to take care of himself. However, he was not completely physically able, which is where visiting home healthcare came in handy. Family members did not take care of him, it was the home health care. In the case of this lady's family, all they have to do is decline responsibility and encourage her to call home health care. The only way this lady can be forced against her will to go into a home is if she becomes incompetent like my friend did toward the end of his time in the free world. It wasn't until he became such a big problem, much bigger for any of us to handle that the right people who work well and authority had a little discussion with him. Actually the fire chief was the one who had that discussion with my friend because he was abusing the system and it's resources. This became very obvious, and everyone around him became very suspicious. As long as someone is mentally competent to make their own decisions then they can't be forced into a home against their will until they become such a problem that they can no longer live on their own. I dealt with two cases pretty close together, and I learned a lot from the first one. It was actually our local APS that specified that as long as someone can successfully make their own decisions, they cannot be forced anywhere against their will. By the time I started dealing with the second case, I took all of my knowledge with me the plan I had learned before. This is exactly why I can say that as long as someone can make their own decisions, they cannot be forced against their will to do anything or go anywhere. I was informed by our local APS about this, and this is how I know what I'm talking about because I don't with it twice. When someone is declared competent, if that responsibility to take care of themselves and not rely on others. When extra help is needed, that's what home healthcare is for. We have a local passport program, and it was the passport program but then for the second case I dealt with. The passport program included healthcare and free meals. More than once I remember home health aides and visiting nurses coming in to care for my friend. Not one was a blood relative, and he happened to be a veteran, which was in his favor. Even those who are not veterans have access to home health care like anyone else who qualifies for extra help. The relatives don't have to accept that responsibility of caregiving, this is optional to each of the blood relatives. It's better for blood relatives to decline rather than to take on more than they can handle. If someone takes on more than they can handle, this puts the patient at risk of being abused by those caregivers. Again, I must reiterate that I do know something about competency because I dealt with two different people, both being competent until they both had to be placed. As long as they were competent, they could not be placed against their will. It was only when they were discovered to later be incompetent that they were placed against their will. The second one who has confrontation by our local fire chief really didn't want to go, but whatever was said became a mutual agreement in the end. This particular person was the one who frequented the ER via squad so much to the point that he had to be placed. By this time he started developing what was suspected to be dementia, which interfered with his competency
The short answer, seeing that your mother is of sound mind, is that no they can't force her admission to a nursing home or hospice care.
Where it gets complicated is that neither can she force them to provide the care she clearly needs. If she is determined to stay at home, then it is also her ultimate responsibility to to accept that her nursing care has to be provided by competent people, which is likely to mean paid professionals. Your siblings should assist her with any necessary arrangements, but they should not feel that they are personally obliged to provide personal or nursing care for her.
Nursing your mother at home until the end of her life can be done, even when it becomes challenging. We have a tendency to think that there are lines in the sand - such as loss of continence, dependency on pain relief or respiratory support, paralysis and so on - at which point we, as reasonable people, would naturally decide we should admit defeat. But actually, when it comes to it, it's cope-able with. It's just very hard work. Your siblings need to get more and better qualified people in to help.
Sunshine, you say your mom wants to die at home. Since she is competent, she can make choices for herself, but she is responsible for implementing them. That is, what she cannot do herself, she pays for help to accomplish. Family is not obliged to do any enabling. So, does your mom have the money to pay for what she wants, namely, to die at home?
Then your siblings need to get in touch with her local social workers and see what support they're able to offer. Again, it's a case of helping her to use services to get what she wants, not of providing them personally for her nor - I should say not! - of paying for them for her. But being broke, more or less, doesn't deprive her of her right to make choices according to what is available. Are you in touch with the other family members? How are they getting on?
14sunshine, it could be your siblings are seeing the forest for the trees.... the fact that your Mom wants to stay in her home with the only income being social security tells me your Mom isn't making good choices. If she was making good choices then she would realize she cannot afford to remain at home if she can't hire professional caregivers to help her remain there.
Whatever you and your siblings do, do NOT use your own money to help her remain in her house. If might be possible that your Mom could qualify for Medicaid where Medicaid will help pay for her care in a nursing home.
If Mom is eligible for hospice, has she considered having hospice come in to her home? That would not solve the problem of the need for home care, but it would provide a measure of comfort.
What is her prognosis? Is she actively dying now?
Many, perhaps most of us, would prefer to die in our own homes. When our loved ones can make that happen, it is a blessing. Realistically it is not always possible to have what we want.
I want to live in a fancy hotel, with good room service and at least two nice restaurants. I want to be driven to plays and concerts often. I want to have guests in to dine with me. Boy, I'd really like that! Why don't I live the rest of my life like that? Because I can't afford it! Sometimes simple economic reality gets in the way of our preferences.
If your family can figure out how to keep Mom in her home for the rest of her life, go for it! (And then would they start working on how I can live in a luxurious hotel?)
If the reality is that Mom can't afford what she wants, none of you should feel guilty or be mad at each other about this.
It shocks me how unrealistic some elderly people, and even their families, can be. I have worked in a nursing home, and did consulting to nursing homes. If you pick a good one, she will get excellent care. If she plots and plans like one writer's mother did, that just shows how mentally incompetent she really is, not to mention selfish and self centered. Sorry if I sound negative, but I am 79 and my husband and I have plans to move to a facility that has independent living through nursing home, because I will NOT put that kind of burden on my children.
We're kind of in this situation. Mother had numerous falls after her first hip surgery--and yep, those EMS calls cost her a bundle. IF she has the 2nd hip surgery she wants, she may not be able to make the "choice" to return home as she wants. She thinks she's in the driver's seat, but she's not the one who will make that decision if she can't stand, help dress or toilet herself, she'll be moved. She is already angry about the subject even being brought up--but daddy purchased a "long term care policy" for this exact scenario. He did not want us to go through, with Mother, what we went through with him. Also, she's a real pill, so I KNOW he looked ahead and thought "I don't want the kids to spend 10 years babying her"....I don't know the ins and outs of how we'd go about placing her "against her will" but I know if she pushes through and has this 2nd hip replacement, she will be wheelchair bound and likely the dr will place her. He's said as much (maybe as a threat to MAKE her do PT, I don't know). We'll see, but I would be very surprised if at some point in the near future, we have to find a home for her.
If/when you have to find a nursing home or assisted living for your parent, check the ratings on www.medicare.gov. They do yearly inspections and have a ton of good info on their site on every nursing home in the country that accepts Medicare. Also, you can apply in your county for Medicaid or its equivalent for financial help in paying for the nursing home care if your parent does not have sufficient means to pay her/himself. Best to do that in advance. You don't want to have your parent in a facility that does not provide good care, and there are a lot of them that are inferior, unfortunately. Do your homework before the emergency arises.
Good comments, Jeanne. My parents believed Social Security would see them well into their dotage. So sad. They were forced to sell their home many years ago...they had 3 mortgages on it. They moved in with brother, who built on to his house for them. Dad passed 11 years ago, Mother is going to live forever (!) Yes, she would LOVE to be waited on hand and foot and taken places and cooed over--but they didn't SAVE or PLAN for old age. Mother gets by on SS as she has really, no bills other than her many, many medications and her shopping addictions. Sadly, we will not be able to afford the kind of care she is going to require in a year or so. She wants to die at home, and she might get that wish, but the reality it, she can't probably afford it. SuzyQB--Hubby and I also have that plan. We are already looking to downsize when he retires. I'm only 59 and very active. We do NOT want to be burdens to our kids. Also, sweet as my kids are (all 5 have said "we have a place for you when you're old"), I really don't want that. Having seen what a burden this has placed on my brother's family--no thank you. I may spend every cent of my kids' inheritances keeping that wish, but they'd rather I was independent and cared for away from them, I'm sure.
Amen, midkid! My parents did plan and did save, thank God!!! Though they were both public school teachers, not a particularly well paying job but one with a good retirement package - they were able to save a hefty chunk of change. Sure, I would love to inherit that money but as it is, I'm more than happy to spend it on whatever it takes to keep my mom well cared for, as happy as possible and as far away from my house as possible.
Rainmom, my parents saved big time and wouldn't update anything unless it was so broken that duct tape wouldn't fix it. And they thought everything they saved would go to me once they passed on....
Well, Dad was in for a huge shock when he found out how much professional caregivers cost for him, and how much Mom's nursing home cost which all came to $30k a month. For Dad when he was fresh out of college $30k would be like 6 years worth of salary, so seeing it go in just one month he couldn't wrap his brain around that.
Oh how I had wished, begged, pleaded with my parents [90's] to downsize out of their house and move to Assisted Living.... you'd think I was asking them to move into a high security prison with guards.
As many of us here know, it usually takes a crises to get an elder to move someplace safer. Lately I have heard of so many major falls being the catalyst.
The problem with using home health care is that they don't provide 24/7 care, which seems to be what the OP's mother needs. It's not surprising that some of the siblings don't want to do it either. Especially if the parent is not dying imminently buy slowly dwindling away over months or years.
freqflyer I think a major fall is usually the catalyst for entry into AL or a NH but those with dementia can really hurt themselves. I wasn't living in the UK at the time but I recall hearing that my grandma would get up at 2 a.m. to wait for the milkman ... maybe he was cute lol ... and when my dad dropped by all four burners on the stove were on high with nothing on them.
They can't force her. But what is the current situation of your mother? Does she need 24/7 assist? If, then you or your siblings should look for nurse. Don't send her nursing home against her willing.
Sowdha - don't send her unless she's willing? Hire a nurse?! Either you a. Have a ton of money. B. Have the most fabulous insurance ever written or C. Have never been through this. My mom needs 24/7 care - I actually looked into a nurse - at a minimum we were looking at $18,000. a month - then there's all the daily living costs at about $10,000 - 12,000. At this rate mom would be out of money long before she passes - very more than likely. Then she would end up in a medicad funded nursing home. Yea - that's way better!
If she meets the criteria for not being able to stay alone in her house. They would need doctors to verify she cannot manage on her own, and then petition a court to rule on this matter. Who has MPOA or DPOA? Whoever has that has all the power and it sounds like your siblings are in agreement about her care (sometimes rare).
Hiring home healthcare company a big blessing if you have other people who are willing to come in and sit with the person when the home healthcare is not there. No, home health care doesn't give 24 seven care, that's why having someone to come in and sit with the elder in between times is a big blessing. What's also a blessing is that if that elder can make friends with the visitors and they can go do stuff together. The last person I dealt with was happy to have someone to run around with. He was so happy to have someone else around went home healthcare was not there because he could not stand to be alone at night specifically. In fact, it turned out that I was the one closest to him in the end. He really didn't want me to go home at night if at all. In fact, he got a spare bed for me so that I can stay overnight with him so that he would not be alone. During the day, we would run around together and sometimes even go out to eat. We often talk turns buying dinner if we ordered out. Those were the good old days! I'm so sorry that he had to end up going into a nursing home in the end before he was finally transferred to an old veterans home. I hope that my experience will help someone get creative and come up with some ideas to keep the elderly person at home longer. Having someone willing to come in and sit with the elder and visit with them really can make a huge difference. The visitor can actually come in and do any like tasks such as light cleaning or even a few dishes. The visitor can even prepare easy to fix microwave meals. My job with my friend was really rather easy, and I even got to run errands for him. He did not want to go into a nursing home either, (and I don't blame him). You don't necessarily have to be the one paying the money that you cannot afford toward hiring in home health care. That service should come out of the pocket of the person needing it if they don't have some kind of insurance to cover it. Last I knew, there was a law passed that requires everyone to have some kind of coverage or pay a fine. You may want to look at your mom's health insurance and even give them a call. Tell them the situation and that she needs in-home healthcare. See if they will cover it. If possible, try to talk to a supervisor. If the insurance won't cover in-home healthcare, see if you can switch her to someone who will cover it.
14sunshine, you could step up and stay there 24/7 or is that not possible? If you can't get her out of bed, can you change a diaper? Sometimes we have to know our limits. Nobody gets forced into Hospice, so she must have signed something along the way.
My Uncle raised hiss step-daughter from age nine but he gave her son POA. Problem stepdaughter had influence over her son. My Uncle had a stroke but did not debilitate him. My Aunt was having health problems but both could still do for each other. Stepdaughter told them she was taking them to see an ALfacility. When they got there, room was ready for them. My Aunt hated it till the day she died. So, yes they may be able to force them.
If she is competent she can make her own decisions. If not the POA USUALLY has the power to choose and move her to an appropriate facility.
With more information you may receive more helpful responses.
If the caregivers are burned out, then there is really no choice.
I bought her a rolling walker but she refused to use it around the house, preferring to hang on to the walls and furniture and fell all the time. Eventually, in the middle of the night, she had "the fall", EMS took her to hospital and from there she went to as NH for three years until she passed. She spent those three years hiding in her room, refusing to have anything to do with anyone, plotting and planning to the end how she could get someone to take her out of "jail", wait on her hand and foot, meals cooked to order, room service and instantly running servants ... as I had done ... but, then bedridden, how would she get to the bathroom (if she didn't lose it and someone had to clean not only her but the bed and the whole room of sloshy poop), get a shower, cleaning, laundry.
To the day she died, my mother was fantasizing to go live with someone who could provide all this, but of course that;'s just fantasy.
Your mother is bedridden with dubious bowel control and a catheter. It is time to let her go to a facility where she will have nursing care 24/7. Believe me, however much she doesn't want it, she will be so much better off. You are hanging on to her at home why? Fear, obligation, guilt? Stop it and do what is best for her.
If this lady is mentally competent, then she should really be able to care for herself. If she can't do that, then it's her responsibility to ask for home health care. I had an elderly friend of mine who was very competent and well able to take care of himself. However, he was not completely physically able, which is where visiting home healthcare came in handy. Family members did not take care of him, it was the home health care. In the case of this lady's family, all they have to do is decline responsibility and encourage her to call home health care. The only way this lady can be forced against her will to go into a home is if she becomes incompetent like my friend did toward the end of his time in the free world. It wasn't until he became such a big problem, much bigger for any of us to handle that the right people who work well and authority had a little discussion with him. Actually the fire chief was the one who had that discussion with my friend because he was abusing the system and it's resources. This became very obvious, and everyone around him became very suspicious. As long as someone is mentally competent to make their own decisions then they can't be forced into a home against their will until they become such a problem that they can no longer live on their own. I dealt with two cases pretty close together, and I learned a lot from the first one. It was actually our local APS that specified that as long as someone can successfully make their own decisions, they cannot be forced anywhere against their will. By the time I started dealing with the second case, I took all of my knowledge with me the plan I had learned before. This is exactly why I can say that as long as someone can make their own decisions, they cannot be forced against their will to do anything or go anywhere. I was informed by our local APS about this, and this is how I know what I'm talking about because I don't with it twice. When someone is declared competent, if that responsibility to take care of themselves and not rely on others. When extra help is needed, that's what home healthcare is for. We have a local passport program, and it was the passport program but then for the second case I dealt with. The passport program included healthcare and free meals. More than once I remember home health aides and visiting nurses coming in to care for my friend. Not one was a blood relative, and he happened to be a veteran, which was in his favor. Even those who are not veterans have access to home health care like anyone else who qualifies for extra help. The relatives don't have to accept that responsibility of caregiving, this is optional to each of the blood relatives. It's better for blood relatives to decline rather than to take on more than they can handle. If someone takes on more than they can handle, this puts the patient at risk of being abused by those caregivers. Again, I must reiterate that I do know something about competency because I dealt with two different people, both being competent until they both had to be placed. As long as they were competent, they could not be placed against their will. It was only when they were discovered to later be incompetent that they were placed against their will. The second one who has confrontation by our local fire chief really didn't want to go, but whatever was said became a mutual agreement in the end. This particular person was the one who frequented the ER via squad so much to the point that he had to be placed. By this time he started developing what was suspected to be dementia, which interfered with his competency
Where it gets complicated is that neither can she force them to provide the care she clearly needs. If she is determined to stay at home, then it is also her ultimate responsibility to to accept that her nursing care has to be provided by competent people, which is likely to mean paid professionals. Your siblings should assist her with any necessary arrangements, but they should not feel that they are personally obliged to provide personal or nursing care for her.
Nursing your mother at home until the end of her life can be done, even when it becomes challenging. We have a tendency to think that there are lines in the sand - such as loss of continence, dependency on pain relief or respiratory support, paralysis and so on - at which point we, as reasonable people, would naturally decide we should admit defeat. But actually, when it comes to it, it's cope-able with. It's just very hard work. Your siblings need to get more and better qualified people in to help.
Whatever you and your siblings do, do NOT use your own money to help her remain in her house. If might be possible that your Mom could qualify for Medicaid where Medicaid will help pay for her care in a nursing home.
What is her prognosis? Is she actively dying now?
Many, perhaps most of us, would prefer to die in our own homes. When our loved ones can make that happen, it is a blessing. Realistically it is not always possible to have what we want.
I want to live in a fancy hotel, with good room service and at least two nice restaurants. I want to be driven to plays and concerts often. I want to have guests in to dine with me. Boy, I'd really like that! Why don't I live the rest of my life like that? Because I can't afford it! Sometimes simple economic reality gets in the way of our preferences.
If your family can figure out how to keep Mom in her home for the rest of her life, go for it! (And then would they start working on how I can live in a luxurious hotel?)
If the reality is that Mom can't afford what she wants, none of you should feel guilty or be mad at each other about this.
SuzyQB--Hubby and I also have that plan. We are already looking to downsize when he retires. I'm only 59 and very active. We do NOT want to be burdens to our kids. Also, sweet as my kids are (all 5 have said "we have a place for you when you're old"), I really don't want that. Having seen what a burden this has placed on my brother's family--no thank you. I may spend every cent of my kids' inheritances keeping that wish, but they'd rather I was independent and cared for away from them, I'm sure.
Well, Dad was in for a huge shock when he found out how much professional caregivers cost for him, and how much Mom's nursing home cost which all came to $30k a month. For Dad when he was fresh out of college $30k would be like 6 years worth of salary, so seeing it go in just one month he couldn't wrap his brain around that.
Oh how I had wished, begged, pleaded with my parents [90's] to downsize out of their house and move to Assisted Living.... you'd think I was asking them to move into a high security prison with guards.
As many of us here know, it usually takes a crises to get an elder to move someplace safer. Lately I have heard of so many major falls being the catalyst.
Does she need 24/7 assist? If, then you or your siblings should look for nurse. Don't send her nursing home against her willing.